Large cell non-Hodgkin lymphoma of childhood

Clinical characteristics and outcome

John T. Sandlund, Victor Santana, Minnie Abromowitch, Raul Ribeiro, Hazem Mahmoud, Gregory D. Ayers, Jin Sying Lin, Robert E. Hutchison, Costan W. Berard, Carol A. Greenwald, William M. Crist, Ching Hon Pui

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Less is known about the clinical features and treatment outcome in pediatric large cell non-Hodgkin lymphoma (NHL) than the lymphoblastic and small noncleaved cell subtypes of NHL. To characterize presenting features and assess possible risk factors associated with this diagnosis, we analyzed data for 91 patients treated on a succession of multiagent regimens from 1975 to 1990. Five-year event-free survival (EFS) (± SE) was related to disease extent (St Jude system): stage I (n = 24), 95% ± 5%; stage II (n = 20), 84% ± 9%; stage III (n = 38), 50% ± 10%; and stage IV (n = 9), 22% ± 11%. Advanced stage disease, age ≤5 years and serum LDH > 500 U/l were associated with poorer EFS in the univariate model (p < 0.001, 0.005, and 0.002, respectively). In the multivariate model, advanced stage and age retained prognostic significance (p = 0.001 and 0.02, respectively), but LDH did not. Among limited stage cases, age ≤5 years was the only adverse risk feature (p = 0.016); treatment era (pre- vs. post-1979) was the only significant feature in patients with advanced disease (p = 0.004). Intrathoracic primaries were associated with a better outcome than other sites among the 38 stage III patients (p=0.005). Only one of eight patients with bone marrow disease remains failure-free. The excellent results for limited stage pediatric large cell NHL permit consideration of treatment modifications to decrease toxicity; for cases with advanced disease, especially those with bone marrow involvement, novel therapeutic approaches are clearly needed.

Original languageEnglish (US)
Pages (from-to)30-34
Number of pages5
JournalLeukemia
Volume8
Issue number1
StatePublished - Jan 1 1994

Fingerprint

Non-Hodgkin's Lymphoma
Disease-Free Survival
Bone Marrow Diseases
Pediatrics
Therapeutics
Bone Marrow
Serum

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Sandlund, J. T., Santana, V., Abromowitch, M., Ribeiro, R., Mahmoud, H., Ayers, G. D., ... Pui, C. H. (1994). Large cell non-Hodgkin lymphoma of childhood: Clinical characteristics and outcome. Leukemia, 8(1), 30-34.

Large cell non-Hodgkin lymphoma of childhood : Clinical characteristics and outcome. / Sandlund, John T.; Santana, Victor; Abromowitch, Minnie; Ribeiro, Raul; Mahmoud, Hazem; Ayers, Gregory D.; Lin, Jin Sying; Hutchison, Robert E.; Berard, Costan W.; Greenwald, Carol A.; Crist, William M.; Pui, Ching Hon.

In: Leukemia, Vol. 8, No. 1, 01.01.1994, p. 30-34.

Research output: Contribution to journalArticle

Sandlund, JT, Santana, V, Abromowitch, M, Ribeiro, R, Mahmoud, H, Ayers, GD, Lin, JS, Hutchison, RE, Berard, CW, Greenwald, CA, Crist, WM & Pui, CH 1994, 'Large cell non-Hodgkin lymphoma of childhood: Clinical characteristics and outcome', Leukemia, vol. 8, no. 1, pp. 30-34.
Sandlund JT, Santana V, Abromowitch M, Ribeiro R, Mahmoud H, Ayers GD et al. Large cell non-Hodgkin lymphoma of childhood: Clinical characteristics and outcome. Leukemia. 1994 Jan 1;8(1):30-34.
Sandlund, John T. ; Santana, Victor ; Abromowitch, Minnie ; Ribeiro, Raul ; Mahmoud, Hazem ; Ayers, Gregory D. ; Lin, Jin Sying ; Hutchison, Robert E. ; Berard, Costan W. ; Greenwald, Carol A. ; Crist, William M. ; Pui, Ching Hon. / Large cell non-Hodgkin lymphoma of childhood : Clinical characteristics and outcome. In: Leukemia. 1994 ; Vol. 8, No. 1. pp. 30-34.
@article{383e1268fddd466f92c6d6d2231fb499,
title = "Large cell non-Hodgkin lymphoma of childhood: Clinical characteristics and outcome",
abstract = "Less is known about the clinical features and treatment outcome in pediatric large cell non-Hodgkin lymphoma (NHL) than the lymphoblastic and small noncleaved cell subtypes of NHL. To characterize presenting features and assess possible risk factors associated with this diagnosis, we analyzed data for 91 patients treated on a succession of multiagent regimens from 1975 to 1990. Five-year event-free survival (EFS) (± SE) was related to disease extent (St Jude system): stage I (n = 24), 95{\%} ± 5{\%}; stage II (n = 20), 84{\%} ± 9{\%}; stage III (n = 38), 50{\%} ± 10{\%}; and stage IV (n = 9), 22{\%} ± 11{\%}. Advanced stage disease, age ≤5 years and serum LDH > 500 U/l were associated with poorer EFS in the univariate model (p < 0.001, 0.005, and 0.002, respectively). In the multivariate model, advanced stage and age retained prognostic significance (p = 0.001 and 0.02, respectively), but LDH did not. Among limited stage cases, age ≤5 years was the only adverse risk feature (p = 0.016); treatment era (pre- vs. post-1979) was the only significant feature in patients with advanced disease (p = 0.004). Intrathoracic primaries were associated with a better outcome than other sites among the 38 stage III patients (p=0.005). Only one of eight patients with bone marrow disease remains failure-free. The excellent results for limited stage pediatric large cell NHL permit consideration of treatment modifications to decrease toxicity; for cases with advanced disease, especially those with bone marrow involvement, novel therapeutic approaches are clearly needed.",
author = "Sandlund, {John T.} and Victor Santana and Minnie Abromowitch and Raul Ribeiro and Hazem Mahmoud and Ayers, {Gregory D.} and Lin, {Jin Sying} and Hutchison, {Robert E.} and Berard, {Costan W.} and Greenwald, {Carol A.} and Crist, {William M.} and Pui, {Ching Hon}",
year = "1994",
month = "1",
day = "1",
language = "English (US)",
volume = "8",
pages = "30--34",
journal = "Leukemia",
issn = "0887-6924",
publisher = "Nature Publishing Group",
number = "1",

}

TY - JOUR

T1 - Large cell non-Hodgkin lymphoma of childhood

T2 - Clinical characteristics and outcome

AU - Sandlund, John T.

AU - Santana, Victor

AU - Abromowitch, Minnie

AU - Ribeiro, Raul

AU - Mahmoud, Hazem

AU - Ayers, Gregory D.

AU - Lin, Jin Sying

AU - Hutchison, Robert E.

AU - Berard, Costan W.

AU - Greenwald, Carol A.

AU - Crist, William M.

AU - Pui, Ching Hon

PY - 1994/1/1

Y1 - 1994/1/1

N2 - Less is known about the clinical features and treatment outcome in pediatric large cell non-Hodgkin lymphoma (NHL) than the lymphoblastic and small noncleaved cell subtypes of NHL. To characterize presenting features and assess possible risk factors associated with this diagnosis, we analyzed data for 91 patients treated on a succession of multiagent regimens from 1975 to 1990. Five-year event-free survival (EFS) (± SE) was related to disease extent (St Jude system): stage I (n = 24), 95% ± 5%; stage II (n = 20), 84% ± 9%; stage III (n = 38), 50% ± 10%; and stage IV (n = 9), 22% ± 11%. Advanced stage disease, age ≤5 years and serum LDH > 500 U/l were associated with poorer EFS in the univariate model (p < 0.001, 0.005, and 0.002, respectively). In the multivariate model, advanced stage and age retained prognostic significance (p = 0.001 and 0.02, respectively), but LDH did not. Among limited stage cases, age ≤5 years was the only adverse risk feature (p = 0.016); treatment era (pre- vs. post-1979) was the only significant feature in patients with advanced disease (p = 0.004). Intrathoracic primaries were associated with a better outcome than other sites among the 38 stage III patients (p=0.005). Only one of eight patients with bone marrow disease remains failure-free. The excellent results for limited stage pediatric large cell NHL permit consideration of treatment modifications to decrease toxicity; for cases with advanced disease, especially those with bone marrow involvement, novel therapeutic approaches are clearly needed.

AB - Less is known about the clinical features and treatment outcome in pediatric large cell non-Hodgkin lymphoma (NHL) than the lymphoblastic and small noncleaved cell subtypes of NHL. To characterize presenting features and assess possible risk factors associated with this diagnosis, we analyzed data for 91 patients treated on a succession of multiagent regimens from 1975 to 1990. Five-year event-free survival (EFS) (± SE) was related to disease extent (St Jude system): stage I (n = 24), 95% ± 5%; stage II (n = 20), 84% ± 9%; stage III (n = 38), 50% ± 10%; and stage IV (n = 9), 22% ± 11%. Advanced stage disease, age ≤5 years and serum LDH > 500 U/l were associated with poorer EFS in the univariate model (p < 0.001, 0.005, and 0.002, respectively). In the multivariate model, advanced stage and age retained prognostic significance (p = 0.001 and 0.02, respectively), but LDH did not. Among limited stage cases, age ≤5 years was the only adverse risk feature (p = 0.016); treatment era (pre- vs. post-1979) was the only significant feature in patients with advanced disease (p = 0.004). Intrathoracic primaries were associated with a better outcome than other sites among the 38 stage III patients (p=0.005). Only one of eight patients with bone marrow disease remains failure-free. The excellent results for limited stage pediatric large cell NHL permit consideration of treatment modifications to decrease toxicity; for cases with advanced disease, especially those with bone marrow involvement, novel therapeutic approaches are clearly needed.

UR - http://www.scopus.com/inward/record.url?scp=0027953586&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027953586&partnerID=8YFLogxK

M3 - Article

VL - 8

SP - 30

EP - 34

JO - Leukemia

JF - Leukemia

SN - 0887-6924

IS - 1

ER -